患有 pertussis 和 hyperleukocytosis 接受交换输血的儿童的死亡风险因素:单中心回顾性队列研究
Xiaoying Wu1, Ruling Yang1, Hongmei Xu1
1Department of Infectious Diseases, National Clinical Research Center for Children and Adolescent's Health and Diseases, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, The First batch of key Disciplines On Public Health in Chongqing, Children's Hospital of Chongqing Medical University, No. 136 Zhongshaner Road, Yuzhong District, Chongqing, 400014, China.
Italian journal of pediatrics
|March 4, 2026
概括
交换输血 (ET) 可以改善与百日咳相关的高白细胞症儿童的生存率. 关键的死亡预测因素包括年轻的年龄,较高的白细胞计数和在ET前的心血管衰竭.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 传染病 传染病 传染病
- 血液学 血液学 血液学
背景情况:
- 百日咳 (百日咳) 可以导致超白细胞症,这是一种危险高的白细胞计数的疾病,导致儿童死亡率显著.
- 交换输血 (ET) 是一种挽救生命的治疗方法,但鉴定尽管有ET,但死亡风险最高的儿童对于优化护理至关重要.
研究的目的:
- 确定接受交换输血的咳相关超白细胞症儿童死亡率的独立预测因素.
- 通过了解不良结果的风险因素来完善治疗策略.
主要方法:
- 一项回顾性队列研究分析了44名患有 pertussis 相关的超白细胞症的儿童,这些儿童接受了 ET 治疗.
- 为了进行比较,患者被分为生存率和死亡率组.
- 多变量逻辑回归确定了死亡的独立预测因素.
主要成果:
- 死亡率组在发病时平均年龄较小 (55 vs 103天) 和高峰白血细胞 (WBC) 计数 (82.19 vs 68.10 × 109/L).
- 在ET前的心血管衰竭在死亡率组 (94.1%与22.2%) 显著更常见.
- 死亡率的独立预测因素包括ET前心血管衰竭 (OR 53.69),高峰白细胞计数 (OR 1.09) 和发病时年龄较小 (OR 0.97).
结论:
- 发病时年龄较小,严重的白细胞病变和ET前心血管衰竭与咳相关的高白细胞病变的死亡率增加有关.
- 这些发现有助于识别高风险患者,强调早期识别和及时的支持性管理.
- 需要进一步的前性研究来验证这些预测因素并优化治疗策略.
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